Background
Acute kidney injury (AKI) occurs in 30% of patients undergoing complex cardiovascular
surgery, and renal ischemia-reperfusion (I/R) injury is often a contributing factor.
A recent meta-analysis observed that perioperative natriuretic peptide administration
was associated with a reduction in AKI requiring dialysis in cardiovascular surgery
patients. This study was designed to further clarify the potential reno-protective
effect of brain natriuretic peptide (BNP) using an established rat model of renal
I/R injury.
Methods
The study comprised three groups (n = 10 kidneys each): (1) control (no injury); (2) I/R injury (45 min of bilateral
renal ischemia followed by 3 h of reperfusion); and (3) BNP (I/R injury plus rat-BNP
pretreatment at 0.01 μg/kg/min). Glomerular filtration rate (GFR) and a biomarker
of AKI, urinary neutrophil gelatinase-associated lipocalin (uNGAL), were measured
at baseline and at 30 minute intervals post-ischemia. Groups were compared using two-way
repeated measures analysis of variance (mean ± SD, significance P < 0.05).
Results
Baseline GFR measurements for control, I/R, and BNP groups were 1.07 ± 0.55, 0.88
± 0.51, and 1.03 ± 0.59 mL/min (P = 0.90), respectively. Post-ischemia, GFR was significantly lower in I/R and BNP
compared with controls at 30 min, 1.29 ± 0.97, 0.08 ± 0.04, and 0.06 ± 0.05 mL/min
(P < 0.01), and remained lower through 3 h, 1.79 ± 0.44, 0.30 ± 0.17, and 0.32 ± 0.12
mL/min (P < 0.01). Comparing I/R to BNP groups, GFR did not differ significantly at any time
point. There was no significant difference in uNGAL levels at 1 h (552 ± 358 versus 516 ± 259 ng/mL, P = 0.87) or 2 h (1073 ± 589 versus 989 ± 218 ng/mL, P = 0.79) between I/R and BNP.
Conclusions
BNP does not reduce the renal injury biomarker, urinary NGAL, or preserve GFR in acute
renal ischemia-reperfusion injury.
Key Words
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Article info
Publication history
Published online: July 21, 2010
Received:
March 15,
2010
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
